In Polish hospitals, tragic mistakes happen every day – up to six people may die as a result of receiving the wrong medication. While public attention focuses mainly on patients, the concept of the so-called “second victim” of medical error – the healthcare professional who unknowingly makes a mistake and then struggles with its emotional, professional, and legal consequences – is gaining recognition. In this context, technology can play a key role – not only in protecting patients but also in safeguarding healthcare workers.
Anatomy of an Error – Where Does the System Fail?
According to studies conducted in the United States in the 1990s, as many as 20% of medical errors involve patient and medication identification. In practice, this means that one in five mistakes results from incorrect drug assignment or misidentification of the patient. Moreover, 38% of medication-related errors occur during the administration process – from preparation and transport to actual delivery.
In many cases, the culprits are similar packaging, illegible labels, manual procedures, and the lack of digital tools to support healthcare staff. Hospitals increasingly invest in advanced clinical technologies – surgical robots, artificial intelligence algorithms, and diagnostic support systems. However, the so-called “gray zone” of hospital operations – logistics, medication management, and medical supplies – lags behind. Paper still dominates, and many tasks are performed manually, increasing the risk of errors.
The Second Victim – Staff in the Shadow of Tragedy
A medical error is not only a tragedy for the patient and their family. It is also a trauma for the doctor, nurse, or pharmacist who – often with the best intentions – made the mistake. In medical literature, the term “second victim” increasingly refers to the person who experiences severe stress, guilt, burnout, and even depression. The lack of systemic support for staff after a medical error can lead to further mistakes, leaving the profession, or long-term mental health damage.
Countries such as the USA and the UK have programs to support “second victims” – psychological teams, mentoring, and debriefing procedures. In Poland, this topic is only beginning to gain attention. Therefore, creating a culture of safety is essential – one where an error is not treated as a personal failure but as a signal to improve the system.
Technology as a Protective Shield
There are ready-to-use solutions that can significantly improve patient safety and the working conditions of nursing staff. A key element is barcode scanning, which remains the cheapest and most effective way to automatically capture data.
To implement such a process, appropriate IT infrastructure is necessary, but most hospital information systems (HIS) available on the Polish market already have the required functionalities. The foundation of a digital medication preparation, administration, and registration process should be an electronic medical order.
Hospitals are increasingly using automated medication dispensing systems, which enable safe and precise drug delivery according to electronic prescriptions. Integrating these devices with hospital IT systems further streamlines staff workflows, reduces error risk, and improves medication management. Combined with mobile medical terminals resembling smartphones, the entire process becomes more efficient and user-friendly.
Education and Digital Competence – The Foundation of Safe Transformation
Effective digitization is impossible without investing in healthcare staff competencies. Technology cannot be treated as an “add-on” to a doctor’s or nurse’s work – it must become an integral part of daily practice. Therefore, introducing educational programs on quality management, medication safety, and IT system operation is crucial. Training should cover not only technical aspects but also ethical and communication skills – teaching how to respond to errors, report them, and support colleagues after difficult incidents. Only an informed, well-prepared team can fully leverage technology and build a safety culture that protects both patients and staff.
Barriers and Challenges
Although the benefits of digitization are clear, implementing technology faces numerous obstacles. First – legislative. Polish law lacks clear regulations on digital medication and medical supply management. Second – financial. Many hospitals lack funds for infrastructure modernization. Third – cultural. Healthcare staff often fear technology, viewing it as a threat to professional autonomy.
Additionally, the lack of interoperability between IT systems means data is not shared across facilities, hindering continuity of care. There are still no standardized guidelines for medical data security, raising concerns about patient privacy.
Towards Safety – A Shared Responsibility
Protecting patients and staff from medical errors is not only about technology but also about organizational culture. Training, procedures, psychological support, and open communication are essential. Technology can be a powerful tool – but only when embedded in a system that prioritizes quality, transparency, and empathy. By measuring, analyzing, and improving processes, we can truly protect those on the front lines: patients and healthcare professionals. In the era of digital transformation, healthcare must go hand in hand with human care – for those who heal and those who need healing.
Anna Gawrońska, PhD – innovation specialist. For 20 years, she has been supporting hospitals and manufacturers in managing the flow of medical products. By collaborating with IT companies, regulatory bodies, and industry associations, she helps implement solutions that enhance patient safety and improve the working conditions of nursing staff. She advises on the implementation of GS1 barcodes in compliance with regulatory requirements. Author of over 90 publications and participant in more than 60 industry conferences.